• IMMUNE NETWORK
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• 제23권3호
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• pp.25.1-25.15
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• 2023

Mucosal environments harbour lymphocytes, which express several adhesion molecules, including intestinal homing receptors and integrin αE/β7 (CD103). CD103 binds E-cadherin, an integrin receptor expressed in intestinal endothelial cells. Its expression not only enables homing or retention of T lymphocytes at these sites but is also associated with increased T lymphocyte activation. However, it is not yet clear how CD103 expression is related to the clinical staging of breast cancer, which is determined by factors such as the size of the tumor (T), the involvement of nearby lymph nodes (N), and presence of metastasis (M). We examined the prognostic significance of CD103 by FACS in 53 breast cancer patients and 46 healthy controls enrolled, and investigated its expression, which contributes to lymphocyte recruitment in tumor tissue. Patients with breast cancer showed increased frequencies of CD103⁺, CD4⁺CD103⁺, and CD8⁺CD103⁺ cells compared to controls. CD103 was expressed at a high level on the surfaces of tumor-infiltrating lymphocytes in patients with breast cancer. Its expression in peripheral blood was not correlated with clinical TNM stage. To determine the localisation of CD103⁺ cells in breast tissue, tissue sections of breast tumors were stained for CD103. In tissue sections of breast tumors stained for CD103, its expression in T lymphocytes was higher compared to normal breast tissue. In addition, CD103⁺ cells expressed higher levels of receptors for inflammatory chemokines, compared to CD103^- cells. CD103⁺ cells in peripheral blood and tumor tissue might be an important source of tumor-infiltrating lymphocyte trafficking, homing, and retention in cancer patients.

• 대한영상의학회지
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• 제83권1호
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• pp.3-27
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• 2022

심장 전산화단층촬영은 비약적인 기술발전과 다양한 연구 결과를 바탕으로 심혈관위험 계층화와 치료 결정을 위한 관상동맥 질환의 진단과 예후 평가성능이 입증되었다. 전산화단층촬영 관상동맥조영술은 폐쇄성 관상동맥 질환에 대한 음성 예측도가 높아서 침습적 혈관조영술의 빈도를 줄일 수 있는 관상동맥 질환 관련 검사의 관문으로 부상했지만, 진단특이도가 상대적으로 낮다. 하지만 심장 전산화단층촬영을 이용한 분획혈류예비력과 심근관류를 분석하여 관상동맥 질환의 혈역학적 유의성을 확인하는 기능적 평가를 통해 그 한계를 극복할 수 있다. 최근에는 이를 보다 객관적이고 재현 가능하도록 인공지능을 접목하는 연구들이 활발히 진행되고 있다. 본 종설에서는 심장 전산화단층촬영의 기능적 영상화 기법들에 대해 알아보고자 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권4호
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• pp.224-235
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• 2024

Purpose: Biliary atresia (BA) is the leading cause of neonatal cholestasis (25-45%). The primary treatment is hepatic portoenterostomy (Kasai procedure), but only 20-40% provide long-term benefits. This study aimed to develop a predictive model for surgical efficacy by comparing preoperative and early postoperative indicators in infants with different outcomes. Methods: We enrolled 166 infants with BA (93 girls, 73 boys) who underwent the Kasai procedure between September 2002 and December 2021, dividing them into favorable or adverse outcome groups. Over 40 parameters were measured, and the diagnostic significance of the prognostic model was evaluated. Results: Kasai surgery was efficacious in 69 patients (42%) and non-efficacious in 97 (58%). Our model assesses efficacy by day 14 after surgery, improving on the <34 µmol/L direct bilirubin threshold established for 3-6 months after the procedure. Including the Desmet fibrosis score refined the model. Conclusion: Blood cholesterol below 5.41 mmol/L, direct bilirubin below 56.3 µmol/L on postoperative days 14±3, and a low Desmet score indicate a high probability of efficacious Kasai surgery in infants with BA.

• Journal of Gastric Cancer
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• 제24권4호
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• pp.391-405
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• 2024

Purpose: Trop family proteins, including epithelial cell adhesion molecule (EpCAM) and Trop-2, have garnered attention as potential therapeutic and diagnostic targets for various malignancies. This study aimed to elucidate the clinicopathological significance of these proteins in gastric carcinoma (GC) and to reinforce their potential as biomarkers for patient stratification in targeted therapies. Materials and Methods: Immunohistochemical (IHC) analyses of EpCAM and Trop-2 were performed on GC and precancerous lesions, following rigorous orthogonal validation of the antibodies to ensure specificity and sensitivity. Results: Strong membranous staining (3+) for Trop-2 was observed in 49.3% of the GC cases, whereas EpCAM was strongly expressed in almost all cases (93.2%), indicating its widespread expression in GC. A high Trop-2 expression level, characterized by an elevated H-score, was significantly associated with intestinal type by Lauren classification, gastric mucin type, presence of lymph node metastasis, human epidermal growth factor receptor 2-positivity, and Epstein-Barr virus (EBV)-positivity. Patients with a high Trop-2 expression level exhibited poorer survival outcomes on univariate and multivariate analyses. High EpCAM expression levels were prevalent in differentiated histologic type, microsatellite instability-high, and EBV-negative cancer, and were correlated with high densities of CD3 and CD8 T cells and elevated combined positive score for programmed death-ligand 1. Conclusions: These results highlight the differential expression of Trop-2 and EpCAM and their prognostic implications in GC. The use of meticulously validated antibodies ensured the reliability of our IHC data, thereby offering a robust foundation for future therapeutic strategies targeting Trop family members in GC.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7719-7724
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• 2014

Background: Lymph node metastasis is believed to be a dependent negative prognostic factor of esophageal cancer. To explore detection methods with high sensitivity and accuracy for metastases to regional and distant lymph nodes in the clinic is of great significance. This study focused on clinical application of FDG PET/CT and contrast-enhanced multiple-slice helical computed tomography (MSCT) in lymph node staging of esophageal cancer. Materials and Methods: One hundred and fifteen cases were examined with enhanced 64-slice-MSCT scan, and FDG PET/CT imaging was conducted for neck, chest and upper abdomen within one week. The primary lesion, location and numbers of metastatic lymph nodes were observed. Surgery was performed within one week after FDG PET/CT detection. All resected lesions were confirmed histopathologically as the gold standard. Comparative analysis of the sensitivity, specificity, and accuracy based on FDG PET/CT and MSCT was conducted. Results: There were 946 lymph node groups resected during surgery from 115 patients, and 221 were confirmed to have metastasis pathologically. The sensitivity, specificity, accuracy of FDG PET/CT in detecting lymph node metastasis were 74.7%, 97.2% and 92.0%, while with MSCT they were 64.7%, 96.4%, and 89.0%, respectively. A significance difference was observed in sensitivity (p=0.030), but not the others (p>0.05). The accuracy of FDG PET/CT in detecting regional lymph node with or without metastasis were 91.9%, as compared to 89.4% for MSCT, while FDG PET/CT and MSCT values for detecting distant lymph node with or without metastasis were 94.4% and 94.7%. No significant difference was observed for either regional or distant lymph node metastasis. Additionally, for detecting para-esophageal lymph nodes metastasis, the sensitivity of FDG PET/CT was 72%, compared with 54.7% for MSCT (p=0.029). Conclusions: FDG PET/CT is more sensitive than MSCT in detecting lymph node metastasis, especially for para-esophageal lymph nodes in esophageal cancer cases, although no significant difference was observed between FDG PET/CT and MSCT in detecting both regional and distant lymph node metastasis. However, enhanced MSCT was found to be of great value in distinguishing false negative metastatic lymph nodes from FDG PET/CT. The combination of FDG PET/CT with MSCT should improve the accuracy in lymph node metastasis staging of esophageal cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3779-3784
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• 2014

Aims: To study alterations of plasma lipid profiles in carcinoma cervix and to assess significance comparedwith controls in different histological grades and stages. Materials and Methods: Totals of 99 histopathologically diagnosed cases and 35 controls from a tertiary hospital situated in the southern part of India which caters the rural and semi-urban populations were considered for the study. Fasting blood samples were taken to analyze total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoproteins cholesterol (LDL-C), for comparison of cases, grouped according to histological grades and stages, and controls. One way ANOVA was used for multiple group comparisons and the Student's t test (unpaired) for group wise comparisons. For all tests a 'p' value of 0.05 or less was considered as significant. Results: Out of 99 cases, most (n-39) were seen in the 40-49 year age group followed by 60-69 years (n-22). Serum TG significantly differed between cases and controls but without any relation to differentiation grade. The lipid profile parameters in various grades of cervical cancer were not statistically significant. Statistically significant increase of TC and LDL-C values was observed with increase in stage of the disease. Conclusions: The study showed TG is elevated in cervical cancer, and that TC and LDL-C are proportional to the spread of cancer as it increases from stage I to stage IV. An in-depth study of molecular changes in lipid metabolism in cervical cancer patients, enzymes/genes responsible and alterations in LDL receptors is necessary to provide information to decide whether the lipid profile has any diagnostic/prognostic role in cervical cancer.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1093-1102
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• 2018

Background/Aims: The aim of this study was to investigate parameters that predict radiation-induced liver disease (RILD) following stereotactic body radiotherapy (SBRT) in patients with hepatocellular carcinoma (HCC) and to identify the clinical significance of RILD. Methods: We retrospectively reviewed the medical records of 117 HCC patients who were treated by SBRT from March 2011 to February 2015. RILD was defined as elevated liver transaminases more than five times the upper normal limit or a worsening of Child-Pugh (CP) score by 2 within 3 months after SBRT. All patients were assessed at 1 month and every 3 months after SBRT. Results: Median follow-up was 22.5 months (range, 3 to 56) after SBRT. RILD was developed in 29 of the 117 patients (24.7%). On univariate analysis, significant predictive factors of RILD were pretreatment CP score (p < 0.001) and normal liver volume (p = 0.002). Multivariate analysis showed that CP score was a significant predictor of RILD (p < 0.001). The incidence of RILD increased above a CP score of 6 remarkably. The rate of recovery from RILD decreased significantly above a CP score of 8. Survival analysis showed that CP score was an independent prognostic factor of overall survival (p = 0.001). Conclusions: CP score is a significant factor to predict RILD in patients with chronic liver disease. RILD can be tolerated by patients with a CP score ${\leq}7$. However, careful monitoring of liver function is needed for patients with a CP score 7 after SBRT.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권2호
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• pp.75-85
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• 2023

Objectives: Suspending bisphosphonates (BPs) to reduce the risk and severity of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. In this study, we quantitatively evaluated the clinical significance of BP suspension before surgery in osteoporosis patients with MRONJ. Materials and Methods: We analyzed 24 osteoporosis patients with MRONJ who were treated from 2012 to 2020 at Seoul National University Dental Hospital and compared the treatment outcomes of those who suspended BPs with those who did not. The number of surgical interventions, follow-up panoramic radiographs for relative bone density measurement, and laboratory blood tests including white blood cells, erythrocyte sedimentation rate, absolute neutrophil count, hemoglobin, hematocrit, and alkaline phosphatase were analyzed. ANOVA, Student's t-test, and Mann-Whitney U tests were used to compare results. Fisher's exact test was used to discover the association between treatment outcome and BP suspension, and Pearson's correlation test was used to measure the statistical relationship between the changes in serum inflammatory markers. Results: The number of interventions was significantly higher in the non-drug suspension group due to recurrence (P<0.05). The relative bone density in patients who suspended BPs was significantly different over time (P<0.05), with the highest density at one-year follow-up. Fisher's exact test shows an association between successful treatment outcomes and BP suspension. The alkaline phosphatase and erythrocyte sedimentation rate levels decreased significantly in the BP-suspended group, and a positive correlation was found between these elevated markers. Conclusion: A significant increase in bone density throughout follow-up and a lower number of interventions were found in the BP suspension group compared to the non-drug suspension group. Also, BP suspension decreased inflammatory markers in the serum after surgery, resulting in good treatment outcomes. BP suspension is a prognostic factor for MRONJ and should be implemented before surgery.

• Journal of Chest Surgery
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• 제38권1호
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• pp.38-43
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• 2005

기질금속단백분해효소-2 (MMP-2)는 기저막과 세포 외 기질의 분해에 작용하여 악성종양의 국소침윤 및 원격전이에 중요한 역할을 담당한다. 본 연구는 수술적인 절제를 시행 받은 제1기 비소세포폐암에서 MMP-2의 활성도를 측정하고 예후인자로서의 의미를 분석하고자 하였다. 대상 빛 방법: 수술 전 방사선 또는 항암제 요법을 시행하지 않은 병리학적 제1기 비소세포폐암 환자 34명을 대상으로 하였다. 폐엽 절제 조직에서 종양 조직과 비종양 조직의 단백질을 각각 추출하여 젤라틴-기질-단백분해효소 분석법을 시행하였다. 결과: MMP-2 활성도는 비종양 조직보다 종양 조직에서 높았다. 종양 조직, 비종양 조직 모두에서 비재발군에 비해 재발군의 MMP-2활성도가 높았으나 비종양 조직에서의 차이가 통계적 유의성이 있었다(p<0.01). 생존율 분석에서도 MMP-2 활성도가 높을 경우 불량한 생존을 보였으며 역시 비종양 조직에서 통계적인 의미가 있었다(p<0.01). 결론: 제1기 비소세포 페암 환자의 절제 폐엽 조직 중 비종양 조직에서의 MMP-2 활성도는 재발 및 생존과 연관성이 있으며 예후 인자로서의 가능성이 있다.